Resumo

FRAGALE, Guillermo et al. Prognostic value of kidney involvement in COVID-19. Rev. nefrol. dial. traspl. [online]. 2022, vol.42, n.1, pp.4-10. ISSN 2346-8548.

Introduction:Acute kidney injuryis a complication described in patients with SARS-CoV-2 infection that is around 0.5-7% of cases.

Objective:evaluate the prognostic value of kidney involvement in patients hospitalized for COVID-19 disease.

Methods:A prospective cohort of patients over 18 years with a diagnosis of COVID-19 disease in the period from May to October 2020 was analyzed. All were followed up until hospital discharge or death.Clinical and biochemicalparameters, Charlson score, mortality and severity of COVID-19 disease were evaluated.

Results:Four hundred twelve patients entered the study, 57% men and mean age 51 ± 16 years. Twenty percent had a Charlson score ≥3, the incidence of acute kidney injury, defined as the increase in serum creatinine 0.3 mg / dl from baseline, was 5.5% (n = 23) and hospital mortality was 2.2% (n = 9). The bivariate and multivariate analysis showed that the male sex [OR= 0.32 (IC 0.12-0.82), p =0.017], D-dimer> 500 ng/ml [OR= 3.68 (IC 1.23-10.96), p = 0.019], urinary protein/creatinine> 0.20 [OR= 2.43 (CI 1.03-5.74), p = 0.043], and AKI [OR= 10.53 (CI 2.99-37.09), p <0.0001] were predictors of severe COVID-19, defined as respiratory rate>30 x min, oxygen saturation <93% or PO2/FIO2300. The univariate analysis of mortality was associated with the development of severe COVID-19 [OR= 68.76 (CI 8.39-563.36), p <0.0001 and acute kidney injury OR= 45.41 (CI 10.45-197.22), p 0.0001.

Conclusion:Renal involvement is associated with worse evolution and higher mortality in COVID-19. The assessment of renal function and proteinuria are accessible parameters that should be included as risk factors in the initial evaluation of these patients.

Palavras-chave : coronavirus; severe acute respiratory syndrome; SARS-CoV-2;acute kidney injury; kidney disease.

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